I have had RRMS relapse despite meds. Can new therapies help?

Question

Hello doctor,

I was diagnosed with relapsing-remitting multiple sclerosis about five years ago, and recently I have been noticing more frequent episodes of numbness in my legs and some vision blurring. I am currently on interferon beta therapy, but have been reading about newer disease-modifying drugs that claim to reduce relapse rates significantly.

Could you explain how these newer medications compare in terms of effectiveness and side effects, and whether switching treatment could slow down long-term disability progression?

Also, is there any new research on lifestyle changes, like diet, vitamin D, or exercise, that might help improve symptoms or quality of life for MS patients like me?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your description, you have had RRMS (relapsing-remitting multiple sclerosis) for five years and have been taking interferon beta. Now you are experiencing leg numbness and blurred vision. This indicates the condition is still active; it could also be an actual relapse or sometimes just a pseudo-relapse if you have been unwell or stressed.

But if it is happening more often, your neurologist might think about switching. Yes, there are newer ones, some oral, some infusions. Generally, they work stronger than interferon, so fewer relapses in many patients.

But with a stronger effect, the side effects are also heavier, such as the risk of infections, infusion reactions, and some rare, serious complications.

Your probable cause can be disease activity progression despite current DMT (N, N-Dimethyltryptamine), and active RRMS despite interferon beta. Some other causes include

Pseudo-relapse (infection, heat-related).
Other demyelinating mimics.
Optic neuritis recurrence.

So, you might need some investigations, such as:

MRI (magnetic resonance imaging) brain and spine with contrast for lesion load/activity.
Vitamin D levels.
CBC (complete blood count).
Liver or kidney function test before any drug change.
Neurologist review for expanded disability status scale (EDSS) scoring.

That is why it is not a straight yes or no and needs an MRI, laboratory tests, and a proper risk check before moving. Switching early if the current one is not doing the job can help slow disability. That is the whole point of these drugs.

But this is not something I would tweak at your physician's level, and I need your neurologist's call after seeing your scans.

Lifestyle changes are needed if vitamin D is low, as it helps with relapse risk. Exercise is suggested, but not overdoing it; light regular activity is good for energy and muscle tone. Diet-wise, nothing magic, but eating a balanced, anti-inflammatory style helps overall health. And avoid smoking completely.

The recommended treatment includes:

The goal from a GP’s (general physician) perspective is to continue interferon until a specialist review.
Ensure no infections.
Maintain optimal vitamin D.
Keep active with supervised physiotherapy.
Discuss escalation to higher efficacy DMT with the neurologist after MRI review.
Avoid abrupt drug stop.

Follow up after MRI and consult a neurologist before any treatment changes. Please update me with the MRI report and vitamin D level so we can track this better, and follow up after specialist review to discuss your next steps in detail.

A few preventive measures that can help you are:

Avoid heat overexposure.
Maintain good sleep and stress control.
No smoking or alcohol excess.
Adequate hydration.

I hope this helps.

Thank you.